MEDICARE: DR. KEVIN HODGES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	9019	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679529424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN HODGES M.D.

Provider Business Mailing Address
First Line	:	357 RICHARDS AVE
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 GRIFFIN RD
Second Line	:	SUITE 15
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7145
Country	:	US
Telephone Number	:	603-431-7393
Fax Number	:	603-430-2195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	01/08/2009

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Directions to “ DR. KEVIN HODGES M.D.” Practice Location

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